ABSTRACT:
Very little is known about the impact of psychosocial
stress on underlying biological mechanisms in African American lupus patients,
although African American women display the highest rates of lupus. Due to the
exposure of African Americans to a unique trajectory of stressors throughout
the life course, it may be critical to understand the relationship between
psychosocial stress and underlying biological mechanisms that influence disease
activity and pathology in this high risk group. To begin to fill this research void, an evidence-based self-management program was piloted among a cohort of African American
lupus patients participating in a SLE database project at the Medical
University of South Carolina (MUSC). To assess disease activity, during each
clinic visit, a history is obtained, and physical examination, phlebotomy, and
urine collection are performed. SLE Disease Activity
Index (SLEDAI) and Systemic Lupus International Collaborating
Clinics/American College of Rheumatology
(SLICC/ACR) Damage Index (SDI) scores
are assessed at each visit. Disease data corresponding with data collection
timeframes for each participant were extracted from the MUSC SLE Database to
assess the effectiveness of the program. Several
differences were observed between the
intervention and control groups on
symptoms pertaining to lupus activity, and many of these differences had
large effect sizes. Our findings can be rapidly translated into improved
delivery of health care and targeted trials/interventions with relevance to
health disparities, and if widely implemented, morbidities and mortality
related to lupus could be drastically reduced in African-Americans.